Disturbance of Sleep and Circadian Rhythm in Hospitalized Patients

Abstract

Sleep and circadian disturbance are common in hospitalized patients. Problems related to sleep induction, frequent awakening, poor sleep quality, and disturbed circadian rhythm including daytime somnolence and nighttime arousal are frequently observed in the hospital. Disturbance of sleep and circadian rhythm could interfere recovery of the patients, prolong the length of stay, and contribute to patient dissatisfaction. Various factors affect sleep and circadian rhythm disturbance in the hospital. Intrinsic factors are related to patients, including medical and psychiatric conditions, uncontrolled pain, prescribed medications, and physical inactivity. External factors related to the hospital environment such as noisy environment, excessive exposure to artificial light, inappropriate humidity, and temperature are also known interrupters for sleep. Medical care provided by professionals, including nighttime vital sign monitoring, phlebotomy, and medication administration, can also contribute to sleep and circadian rhythm disturbances. This review aims to systematically address sleep and circadian rhythm disturbances in hospitalized patients, discuss factors that affect sleep in the hospital, and suggest non-pharmacological and pharmacological treatment options.